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Bladder Cancer

Definitions

  • Initial Work up and Staging refers to imaging studies that are part of the routine evaluation of a patient prior to therapy
  • Restaging After Treatment refers to recommendations for studies to be performed regardless of the clinical status of the patient after completion of an episode of treatment.
  • Evaluation for Change in Clinical Status refers to examinations ordered to evaluate new or worsening signs and symptoms.
  • Surveillance Imaging refers to recommendations for imaging to be performed at intervals following therapy regardless of the clinical status of the patient.

Detection

  • Contrast enhanced CT or MRI of the pelvis

Initial Work Up and Staging

  • Pelvis MRI preferred for local staging, CT acceptable
  • Abdomen and Chest CT if tumor invades bladder wall (Stage T2 or higher)
  • MRI brain if there are neurologic signs or symptoms
  • Bone scan if elevated alkaline phosphatase or symptoms
  • PET may be of value if other studies are equivocal

Restaging after treatment

Evaluation for Change in Clinical Status

  • As clinically indicated

Surveillance Imaging (Patient stable after treatment)

Invasive transitional cel carcinoma

  • CT Chest, Abdomen and Pelvis annually

After cystectomy

  • CT or MRI of the abdomen and pelvis, CT Chest every 3-6 months for 2 years and then as clinically indicated
  • Diagnostic Imaging Oncology; Shaaban et al eds.; Amirsys Corp. 2012; Urinary Bladder Carcinoma p 5-64
  • NCCN Clinical Practice Guidelines in Oncology Bladder Cancer V 1.2012 accessed 12/29/10
  • NCCN Guidelines Version 2.2012 Bladder Cancer accessed 7/8/2012
  • NCCN Guidelines version 1.2012 Bladder Cancer accessed 11/23/2012
  • Schöder H, Larson SM Positron emission tomography for prostate, bladder, and renal cancer. Semin Nucl Med. 2004 Oct;34(4):274-92.
  • Drieskens O, Oyen R, Van Poppel H, Vankan Y, Flamen P, Mortelmans L. FDG-PET for preoperative staging of bladder cancer. Eur J Nucl Med Mol Imaging. 2005 Dec;32(12):1412-7.

Additional Information

Metastasis most likely to

  • Lymph Nodes 69%
  • Bone 47%
  • Lung 37%
  • Liver 26%
  • Peritoneum 16%
  • Pleura 11%
  • Adrenal 7%

References

  • Shinagare, Atul B., Ramaiya, Nikhil H., Jagannathan, Jyothi P., Fennessy, Fiona M., Taplin, Mary-Ellen, Van den Abbeele, Annick D. Metastatic Pattern of Bladder Cancer: Correlation With the Characteristics of the Primary Tumor Am. J. Roentgenol. 2012 196: 117-122

References

  • Diagnostic Imaging Oncology; Shaaban et al eds.; Amirsys Corp. 2012; Urinary Bladder Carcinoma p 5-64
  • NCCN Clinical Practice Guidelines in Oncology Bladder Cancer V 1.2012 accessed 12/29/10
  • NCCN Guidelines Version 2.2012 Bladder Cancer accessed 7/8/2012
  • NCCN Guidelines version 1.2012 Bladder Cancer accessed 11/23/2012
  • Schöder H, Larson SM Positron emission tomography for prostate, bladder, and renal cancer. Semin Nucl Med. 2004 Oct;34(4):274-92.
  • Drieskens O, Oyen R, Van Poppel H, Vankan Y, Flamen P, Mortelmans L. FDG-PET for preoperative staging of bladder cancer. Eur J Nucl Med Mol Imaging. 2005 Dec;32(12):1412-7.
  • Lymph Nodes 69%
  • Bone 47%
  • Lung 37%
  • Liver 26%
  • Peritoneum 16%
  • Pleura 11%
  • Adrenal 7%
  • Shinagare, Atul B., Ramaiya, Nikhil H., Jagannathan, Jyothi P., Fennessy, Fiona M., Taplin, Mary-Ellen, Van den Abbeele, Annick D. Metastatic Pattern of Bladder Cancer: Correlation With the Characteristics of the Primary Tumor Am. J. Roentgenol. 2012 196: 117-122